HIV-Related Skin Disease in the Era of Antiretroviral Therapy: Recognition and Management

Abstract

Anti-retroviral therapy (ART) has revolutionized the treatment and prognosis of people living with HIV (PLHIV). With increased survival and improved overall health, PLHIV are experiencing dermatologic issues both specific to HIV and common to the general population. In this new era of ART, it is crucial for dermatologists to have a strong understanding of the broad range of cutaneous disease and treatment options in this unique population. In this review, we outline the most common skin diseases in PLHIV, including HIV-associated malignancies, inflammatory conditions, and infections, and focus on the role of ART in altering epidemiology, clinical features, diagnosis, and treatment of cutaneous conditions.

The prevalence and spectrum of mucocutaneous disease in South African people living with HIV and accessing care at a district-level hospital

“… 28 Basal cell carcinoma and squamous cell carcinoma comprise the keratinocyte carcinomas and are the most common malignancies worldwide in both the general population and PLWH. 5 , 29 The spectrum of neoplastic conditions observed in this study comprised benign epidermal neoplasms and keratinocyte carcinomas. Condylomata acuminata were observed in four patients, one of whom had concomitant anal squamous cell carcinoma in situ .…”

“…The reported prevalence of PPE in the literature ranges from 11% to 46%. 5 , 23 , 24 Two Ugandan studies have suggested that PPE may be related to an exaggerated immunological reaction to arthropod bites. 23 , 25 The prevalence of PPE in our study may be attributed to its chronicity, its association with increased levels of immunosuppression (one-third of our study population had a CD4+ cell count below 200) and poor socio-economic conditions, which predispose patients to arthropod bites.…”

“… 23 , 25 The prevalence of PPE in our study may be attributed to its chronicity, its association with increased levels of immunosuppression (one-third of our study population had a CD4+ cell count below 200) and poor socio-economic conditions, which predispose patients to arthropod bites. 5 , 18 , 21…”

“…As a result of ART, PLWH are living longer and healthier lives with a near-normal life expectancy. 5 Several of the HIV-associated dermatoses have declined during the ART era, but certain drug reactions and inflammatory skin conditions have increased. 4 , 6 Management of PLWH in the ART era includes addressing common non-infectious dermatoses in addition to rare opportunistic infections and infection-associated malignancies.…”

“… 4 , 6 Management of PLWH in the ART era includes addressing common non-infectious dermatoses in addition to rare opportunistic infections and infection-associated malignancies. 5 …”